- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,052.00 / $5,909.48 / $13,841.56
| Facility | | $2,052.00 | $5,909.48 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,668.81 / $6,768.46 / $11,878.21
| Facility | | $4,668.81 | $6,768.46 | $11,878.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.83 / $266.13 / $497.79
| Facility | | $155.83 | $266.13 | $497.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.57 / $389.72 / $1,555.47
| Facility | | $296.57 | $389.72 | $1,555.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,361.42 / $3,044.00 / $7,772.00
| Facility | | $2,361.42 | $3,044.00 | $7,772.00 |